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Telmisartan in high-risk cardiovascular patients.
Am J Cardiol 2010; 105(1 Suppl):36A-43AAJ

Abstract

Increasing attention is being devoted to the use of combination therapy with angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) in order to achieve maximal blockade of the renin-angiotensin system (RAS) in patients at high risk of cardiovascular events. This approach has been adopted in the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET), which compared the effects of the ARB telmisartan and the ACE inhibitor ramipril, alone and in combination, on cardiovascular mortality and morbidity in high-risk patients with vascular disease or diabetes mellitus and end-organ damage. The results showed that telmisartan was as effective as ramipril for the primary cardiovascular outcome during a 56-month follow-up but was better tolerated. However, dual RAS blockade was not associated with any additional benefits, and the incidence of adverse events was greater with the combination. Based on these findings, optimal cardioprotective strategies in high-risk patients are likely to involve the addition of either telmisartan or ramipril on top of the patient's usual care, but not both. The choice of agent to be used in the long term could be based on other considerations, such as compliance and safety. Both cough and angioedema were higher with ramipril than telmisartan during the 56-month follow-up period in ONTARGET.

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    Authors+Show Affiliations

    Weber MA
    State University of New York Downstate College of Medicine, Brooklyn, New York, USA. Michaelwebermd@cs.com

    MeSH

    Angiotensin II Type 1 Receptor BlockersAngiotensin-Converting Enzyme InhibitorsBenzimidazolesBenzoatesCardiovascular DiseasesDiabetes MellitusHumansKidney DiseasesRamiprilRisk FactorsTelmisartan

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Review

    Language

    eng

    PubMed ID

    20102972

    Citation

    Weber, Michael A.. "Telmisartan in High-risk Cardiovascular Patients." The American Journal of Cardiology, vol. 105, no. 1 Suppl, 2010, 36A-43A.
    Weber MA. Telmisartan in high-risk cardiovascular patients. Am J Cardiol. 2010;105(1 Suppl):36A-43A.
    Weber, M. A. (2010). Telmisartan in high-risk cardiovascular patients. The American Journal of Cardiology, 105(1 Suppl), 36A-43A. doi:10.1016/j.amjcard.2009.10.008.
    Weber MA. Telmisartan in High-risk Cardiovascular Patients. Am J Cardiol. 2010 Jan 4;105(1 Suppl):36A-43A. PubMed PMID: 20102972.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Telmisartan in high-risk cardiovascular patients. A1 - Weber,Michael A, PY - 2010/1/28/entrez PY - 2010/2/5/pubmed PY - 2010/3/5/medline SP - 36A EP - 43A JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 105 IS - 1 Suppl N2 - Increasing attention is being devoted to the use of combination therapy with angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) in order to achieve maximal blockade of the renin-angiotensin system (RAS) in patients at high risk of cardiovascular events. This approach has been adopted in the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET), which compared the effects of the ARB telmisartan and the ACE inhibitor ramipril, alone and in combination, on cardiovascular mortality and morbidity in high-risk patients with vascular disease or diabetes mellitus and end-organ damage. The results showed that telmisartan was as effective as ramipril for the primary cardiovascular outcome during a 56-month follow-up but was better tolerated. However, dual RAS blockade was not associated with any additional benefits, and the incidence of adverse events was greater with the combination. Based on these findings, optimal cardioprotective strategies in high-risk patients are likely to involve the addition of either telmisartan or ramipril on top of the patient's usual care, but not both. The choice of agent to be used in the long term could be based on other considerations, such as compliance and safety. Both cough and angioedema were higher with ramipril than telmisartan during the 56-month follow-up period in ONTARGET. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/20102972/Telmisartan_in_high_risk_cardiovascular_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(09)02483-7 DB - PRIME DP - Unbound Medicine ER -

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